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HomeMy WebLinkAbout1804-0259 I All APPLICABLE INFO MUST BECCOMPLETED FOR APPLICATION TO BE ACCEPTED Date:, L' ' s-ci ( 3' ( 0 Permit Number: i �Lk J n� _, _ ,,_77,:-.-4-/..'" ' ,trAtiti -:,._ ;",_,..,.....,,,,.. ittroh,_ F L C3 R 10 R. p qPR 1..®?O,® Building Permit Application tt,p9O Planning uilding and Code Regulation Division Services •C4c`P c 4a1,ent Building 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax:.(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: . PROPOSED ON'PROVE LOCATIONo - .,�-. . • .: . Address: 1'1'302 yprt Luc2 o(( J.v ( -(72 r+ Puce c g q ct-C1 Legal Description: Property Tax ID#: ! \ ^ So 2 oo69 R —ce>0" Z Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: . DE.fACED DESCRIPTIO "CV WORK:. # P-ipla c.‘71 11_,,v Cone1_1 oA,Ai Sgs1 , i-; (ice 'Per < <(fie . S --o n .,c1 :VI,‘ f Kw I I CONSTRUCTION O ]FORMATIONa .e�.. , '�2. °' Additional work to be performed under this permit-check all that apply: 'Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors 1 —Electric —Plumbing _Sprinklers —Generator _Roof Pitch Total Sq. Ft of Construction:. , . - Sq. Ft.of First Floor: .. Cost of Construction:$ Lit-CI. 1 Utilities: _Sewer _Septic Building Height: OWE ER/LEIS�SEE:' CONTRACTOR? Name A ,'f O 'avi'no 1/ Name: c15wc$ Jr- f cA, z_ �/(o.rk-gin Address: (I3O2 (2e,cii6Qj:'•.IDr V Company: A--'l 4iv So(v-&itsrL•LG City: �G/� Pi cyState:_ Address: A y q s ' 2" ' ea va Zip Code: 34 q 5) Fax: City: Q\<,c.e cL.ab-4-'2- State: iFL— PhoneNo. 77Z -S9S-2- '7b Zip Code: 3 '{17`i Fax: E-Mail: Phone No S&? -2Q/--rO°2- Fill in fee simple Title Holder on next page(if different E-Mail A 'ici y- 1 ,cion so kee p cj w.ec ; t-:con,-. from the Owner listed above) State or County License CAC CZ 1.9 0.1 9- If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. • SUPPalita ALIONSTRWCTION LIEN" a _Not Applicable MORTGAGE COMPANY:v _ Not Applicable ,,. DESIGNER/ENGINEER: Name: • Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: • FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTORAFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before corn, en\cin: work or recording your Notice of Commencement. r Si:�natur- o' a iter/Lessee/Contractor as Agent for Owner Si n ture �,r(trra for/License Holder v STATE 0 LORI* STATE OF FLORIDA COUNTY OF , ( C4 COUNTY OF S-)- •tA.1/4_C-A.12" The forgoing instru ent was acknowledged before me The forgoing instru ent was acknowledged before me this 'U day of 1 ,20 1 .--by this j©day of f r %,\ ,20 \`bby q11.-6 s f st�-�ei mem Maf`A z, O i ' %% 11101 �� Z(N4mofPr.r�oh acknowledging) (Nab : of .e :o I•c nowledging) (Signature of Notaryublic-State of Florida ) (Signature of Notary blic-State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of IdentificatigA - ,3, Produced L a GIVENS t Produced 'Fi I✓-2,,0;n. DEANNAMF�RIEGIVENS DONNR��u�#GG 022023 qI,•;:' " ` = MY COMMISSION#GG 022023 'g„�c: ..,/ SSION 16 2020 i= 'EXPIRES:Decd er .2020 Commission No. � i'._° ; camber Commission No. a �yy!! F 12r.t EX �v p�biicUnderNnt�` I ^•.,--,:•.•• :u d 7hru Nota uo is ndenvnters ° c- ed-fhNNotaN I_..W.'" _��..h x ',iE OF F.,O�• (;Md �r.,s. ,.. w .r I moi::=2inCriA�E • y REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW ' REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED -ley. 7/2014